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Query: UMLS:C1762617 (weakness)
 37,932 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Detailed electrophysiological studies were performed in 4 patients with myeloneuropathy induced by abuse of nitrous oxide for 1 to 4 years. All presented with paresthesias, weakness, and Lhermitte's phenomena, and exhibited signs of sensorimotor polyneuropathy, ataxia, and arreflexia. Two had subnormal serum vitamin B12 levels. Baseline electrophysiologic testing revealed reduced motor unit potentials, prolonged F wave latencies, absent H reflexes, denervation potentials, and delays in motor and sensory conduction. Three had peripheral and nuchal delay after median nerve stimulation. All were reevaluated after 3 to 12 months' abstinence and treatment with vitamin B12, and all showed substantial clinical improvement. Parallel improvement in electrophysiologic findings occurred, but residual minor conduction delays, loss of H reflexes, electromyographic evidence of denervation, or abnormalities of posterior tibial SEP were noted. These findings confirm the reversibility of myeloneuropathy of nitrous oxide abuse and describe the profile of electrophysiologic recovery in subjects who abstain from further neurotoxic exposure.
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PMID:Reversible myeloneuropathy of nitrous oxide abuse: serial electrophysiological studies. 199 94

The central conduction time of the descending and ascending fibers of the spinal cord were examined in patients with radiologically defined cervical spinal stenosis (antero-posterior diameter of the spinal canal less than 13 mm). Nineteen patients were examined, only 4 of whom showed clinical signs of spastic weakness or ataxia. The electromyographic response after non-invasive stimulation of the leg area of the motor cortex was delayed in 13 of the 15 clinically unaffected patients. The central latency (N21-P39) of the somatosensory evoked response after stimulation of the tibial nerve (tibialis SEP) was increased in 12 of the 15 individuals. The 4 patients with clinical signs showed abnormal latencies with both methods. The use of both techniques for the examination of the function of the spinal cord revealed increased latencies in the central motor and/or sensory pathways in all patients. The technique of non-invasive stimulation of the corticospinal system therefore provides an additional tool to detect and quantify subclinical and clinically apparent lesions in patients with defined cervical spinal stenosis.
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PMID:Functional deficits of central sensory and motor pathways in patients with cervical spinal stenosis: a study of SEPs and EMG responses to non-invasive brain stimulation. 248 Feb 25

Acute autonomic and sensory neuropathy (AASN), one subtype of acute pandysautonomia, in which dorsal root ganglia and autonomic ganglia are involved is uncommon. Little is so far known on central nervous system involvement in AASN. In the present paper we described a rare case of AASN associated with the central nervous system manifestations such as galactorrhea-amenorrhea syndrome and intractable anorexia. A 30-year-old woman rapidly developed burning pain and numbness in her arms and legs as well as orthostatic syncope. She had severe anorexia and no no menstruation from onset. On physical examination, she was emaciated. There was marked orthostatic hypotension with tachycardia. Skin was dry. Moderate galactorrhea was detected. Neurological examination showed prominent paresthesia and dullness of superficial sensation, predominantly to pinprick and thermal stimuli, segmentally over the neck, occipital scalp, and extremities. Deep sensation was intact. She had no weakness or ataxia. Deep tendon reflexes were almost normal. NCV and SEP were normal, while EEG was abnormal. Sural nerve biopsy demonstrated axonal degeneration with the loss of myelinated, predominantly in small-caliber fibers, and unmyelinated fibers. The levels of HVA and MHPG in CSF were decreased. The autonomic nervous function tests revealed postganglionic dysfunction. alpha-adrenergic system was predominantly impaired, while beta-adrenergic system was relatively preserved. The endocrinological studies demonstrated mild or moderate elevation of PRL basal value and hyper-response of PRL and LH for TRH and LH-RH loading test, which suggested disorder of the hypothalamo-hypophysial system. Cranial MRI showed moderate dilatation of the 3rd ventricle.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Acute autonomic and sensory neuropathy associated with galactorrhea-amenorrhea syndrome and intractable anorexia]. 255 96

Earlier clinical observations of rapid changes of certain neurological dysfunctions after autotraction treatment of patients with lumbar and sacral root affections have been evaluated by objective registration methods. Isokinetic recordings of maximal voluntary strength showed that in 6 out of 8 patients, weakness of the foot dorsal flexor muscles could be more or less completely restored after one session of autotraction resulting in pain relief. In a group of patients with clinical signs of impaired sensibility, the low or abolished SEP responses to nerve stimulation on the affected side were restituted in 4 out of 5 cases during autotraction. The asymmetric leg skin temperatures in 10 patients with sciatic pain levelled off in the 6 cases obtaining pain relief by the traction. The results suggest a causal relationship between pain relief and restitution of certain neurological deficits.
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PMID:Changes in voluntary muscle strength, somatosensory transmission and skin temperature concomitant with pain relief during autotraction in patients with lumbar and sacral root lesions. 283 15

Somatosensory evoked potentials produced by electrical stimulation of the posterior tibial nerve were recorded from surface electrodes at the scalp and cervical spine of a patient with scoliosis undergoing posterior spinal fusion with Cotrel-Dubousset instrumentation. During spinal derotation when hypotension and anemia were also present, the cortical and subcortical somatosensory evoked potentials disappeared. During a wake-up test, the patient demonstrated weakness of the left lower extremity, and derotation was stopped. The patient was given pharmacologic hypertensive agents and blood transfusions to increase blood pressure. Forty minutes later, somatosensory evoked potentials returned and a second wake-up test demonstrated normal function in both lower extremities. This report demonstrates the accuracy and usefulness of somatosensory evoked potential monitoring during spinal fusion with Cotrel-Dubousset instrumentation. To the authors knowledge, this is the first report demonstrating a correlation between abnormal SEP responses and intraoperative neurologic deficit during the derotation maneuver with Cotrel-Dubousset instrumentation and corrected by transfusion and restoration of normotension.
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PMID:Somatosensory evoked potential monitoring during Cotrel-Dubousset instrumentation. Report of a case. 847 15

We reported an extremely rare case of posttraumatic spinal pseudomeningocele which caused spinal cord compression 20 years after getting injury, and demonstrated that sequelae of an injury may occur many years after the original wound. A 39-year-old man, who got left cervical root avulsion due to a traffic accident when he was 17 years old, began to complain of progressive muscle atrophy and weakness of left lower extremity 1 year ago. Myelography demonstrated pseudomeningocele at left C6-C8 level, and MRI and CT myelography revealed that the pseudomeningocele extends through the intervertebral foramen and compresses the spinal cord to the right side in the spinal canal. Bilateral functional compression of spinal cord dorsal and lateral column was also verified with SEP and MEP electrophysiologically.
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PMID:[A case of posttraumatic spinal pseudomeningocele which caused spinal cord compression 20 years after injury]. 868 88

We reported a 46-year-old woman in whom cerebral sinus thrombosis manifested itself in headache and weakness while she was on an oral estrogen preparation. The neurological examinations revealed monoparesis of the right upper extremity, hyperactive right deep tendon reflex and disturbance of the joint sense, stereognostic sense, two-point discrimination and skin writing sense in the right upper extremity, in addition to tactile extinction. Brain CT showed empty triangle sign. MRI revealed infarction near the left postcentral gyrus and thrombosis of right sigmoid sinus. In the MRA study, there was low signal intensity in the posterior portion of the superior sagittal sinus and right transverse sinus. Short latency SEP in upper extremity showed that the central conduction time was normal, while the amplitude of wave components after N20 was reduced on the right side. Both palms were given bilateral or unilateral pressure stimuli. When event-related potentials (ERP) were evoked, using bilateral stimuli as a rare target, and left unilateral stimuli as a non-target, the P 300 latency was prolonged to 450 msec but was restored to normal with the improvement of tactile extinction. These results seem to suggest that the tactile extinction is ascribable to a disturbance of recognition at the higher brain function level and that ERP can be a useful objective yardstick in the evaluation of extinction phenomenon.
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PMID:[Tactile extinction following the cerebral sinus thrombosis. A study using event-related potentials]. 890 91

The authors report the rare case of a 48-year-old woman with a cervical subpial lipoma unassociated with spinal dysraphism. Her symptoms were progressive weakness and numbness in the four extremities and the neurological symptom of mild cervical myelopathy. Plain radiographs of the cervical spine showed diffuse widening of the spinal canal, which was occupied by a large low-density mass revealed by axial CT scan. MR imaging identified the mass as being dorsolateral to the cord in the intradural region. It was hyperintense on both T1- and T2-weighted images. Axial images with fat suppression sequence clearly showed dorsal nerve roots traveling through the lesions, but the interface between the spinal cord and lesion was not well demarcated. A cervical laminectomy between C3-6 revealed a yellowish subpial mass after the dura was opened. The mass was only partially resected and intraoperative SEP monitoring data remained normal including N20 latency. Histological examination found mature adipose tissue covered by thickened pia mater, which was compatible with a diagnosis of lipoma. After surgery, no complications occurred and the patient's myelopathy subsequently improved. Subpial spinal lipomas unassociated with dysraphism are uncommon and they are reported in only 1% of all spinal cord tumors. They are thought to arise from premature dysjunction of the cutaneous ectoderm during neural tube formation. Without any invasive procedure, MR imaging is indispensable to show their longitudinal dimension as well as their infiltrative extension into the spinal cord. The main purpose of surgery is to decompress the lipoma from the adjacent neural structures, because it is benign in nature and there is no cleavage plane identifiable between the lipoma and the spinal cord.
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PMID:[A case of cervical subpial lipoma]. 1134 14

A 43-year-old man was admitted to our hospital due to unstable walking, head tilting to the left and difficulty in extending his arm. He was quite healthy until the age of 20 years, when these symptoms appeared and progressed slowly afterward. Due to his unstable walking, he started to use a wheelchair when he was 39 years old. He had no family history of similar disease. On admission, neurological examination revealed spasmodic torticollis, ataxic speech and marked limb and truncal ataxia. Myoclonic jerky flexion of the forearm was induced when he raised and extended his forearm. He also showed mild hyperreflexia in the lower limbs without pathological reflexes. He had weakness and atrophy of the left supraspinatus, infraspinatus, deltoid and biceps brachii muscles and mild superficial sensory impairment in the left axillary nerve territory due to cervical spondylotic radiculopathy of the left C5 root. MRI of the brain demonstrated severe bilateral atrophy of the cerebellar hemispheres and vermis but minimal atrophy of the cerebrum and brainstem. Because surface electromyography revealed continuous discharge with phasic components in the biceps and wrist flexor muscles on extending the upper limbs, the jerky flexion movement of the forearm was considered to be primarily dystonia. Although no giant SEP was observed, a C-response was detected in the long-loop reflex in response to right median nerve stimulation. Nuclear examinations showed diffuse hypoperfusion and decreased glucose metabolism in the cerebellum. Based on these findings, we hypothesized that cerebellar dysfunction may have induced severe dystonic movement resembling myoclonus. We would like to name this complicated involuntary movement an "arm thrust". This is the first case to be reported of sporadic, chronic, progressive cerebellar ataxia accompanied by severe dystonic movement, especially on stretching the forearms, that mimics myoclonic movement.
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PMID:[A case of cerebellar ataxia showing severe dystonia masquerading as myoclonic jerky movements on arm extension]. 1235 58

Japanese encephalitis (JE) is an encephalomyelitis involving cortex, subcortex, brainstem and spinal cord. There is paucity of studies on the neurophysiological evaluation in JE. This study aims at comprehensive evaluation of EEG, sensory and motor evoked potentials, nerve conduction and electromyography; and correlate these with clinical findings. Sixty five patients with JE diagnosed on the basis of clinical, radiological and virological criteria were subjected to a detailed clinical evaluation during the acute stage of illness. Cranial CT scan or MRI was carried out in all the patients. All the patients underwent 10 or 18 channel EEG, motor and sensory evoked potentials to both upper and lower limbs bilaterally as well as peroneal and sural nerve conductions and concentric needle EMG. Outcome, was defined at the end of 3 months into poor, partial and complete recovery. The patient's age ranged between 2-65 years. There were 40 males and 25 female patients. Fifteen patients were less than 12 years of age. History of seizure was present in 31 patients. Quadriplegia was seen in 39 and hemiplegia in 8 patients. Muscle wasting was present in 16 patients and tendon reflexes were reduced in 12 and of mixed pattern in 14 patients. Cranial MRI revealed thalamic lesion in 38, basal ganglia in 21, substantia nigra in 30, pons in 5, cerebellum in 3 and cerebral cortex in 7 patients out of 57 patients. EEG revealed nonspecific theta to delta slowing in 45, alpha pattern coma in 5 and epileptiform discharges in 8 patients. EMG revealed fibrillations in 23 patients. Motor evoked potentials were abnormal in 34 out of 46 patients and revealed patchy and focal abnormalities comprising of unrecordable, prolonged and normal pattern. Somatosensory evoked potentials were abnormal in 8 patients only. At 3 month, 26 patients had complete, 13 partial and 15 had poor outcome. Eight patients died in acute stage and 3 were lost to followup. MEP correlated with weakness and 3 month outcome whereas EEG, SEP and EMG did not have any correlation. MEP changes were more frequent in JE and had prognostic significance.
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PMID:Neurophysiological changes in Japanese encephalitis. 1239 49


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